Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Yıl 2018, Cilt: 3 Sayı:3, 186 - 189, 30.11.2018

Önder Karabay Özgür Bostancı

https://doi.org/10.25000/acem.464304

Cited By: 1

Öz

Aim: The
biliary fistula development after liver hydatid cyst surgery is a common
complication. The aim of this study is to examine the factors affecting the
development of postoperative biliary fistula in patients operated for liver
hydatid disease.

Methods: The study was retrospectively performed in patients
treated surgically for liver hydatid cyst between 1999 and 2010. The data of 53
patients operated for hydatid csyt were reviewed with hospital records. Patients
were divided into two groups as biliary fistulas with (Group A) and without biliary
fistula (Group B). The demographic data (age, sex), cyst diameter, cyst
localization, laboratory tests and length of hospital stay were recorded. These
parameters were compared with the groups.

Results: The groups were similar in terms of age and sex (p =
0.790 and p=1.0, respectively). In group A, the mean cyst diameter was
significantly higher than group B (p=0.001). The mean duration of
hospitalization was longer in group A than group B (p=0.001). There was no
difference between the groups considering cyst localization, AST, ALT, total
bilirubin and direct bilirubin (p>0.05 for all).

Conclusion:
Preoperative cyst diameter may be a valuable parameter for predicting biliary
fistula preoperatively. However, larger prospective studies are needed on this
subject.

Anahtar Kelimeler

Hydatid cyst, liver, biliary fistula, ERCP

Karaciğer hidatik kist cerrahisi sonrası safra fistülü: Tahmin edilebilir bir komplikasyon mu?

Öz

Amaç: Karaciğer
hidatik kisti ameliyatı sonrası safra fistülü gelişimi sık bir komplikasyondur.
Bu çalışmanın amacı, karaciğer hidatik hastalığı nedeniyle opere edilen
hastalarda postoperatif bilyer fistül gelişimini etkileyen faktörleri
incelemektir.

Yöntemler:
Çalışma, 1999 ve 2010 yılları arasında karaciğer hidatik kisti nedeniyle
cerrahi olarak tedavi edilen hastalarda retrospektif olarak yapıldı. Hidatik kist için ameliyat edilen 53 hastanın
verileri hastane kayıtları ile gözden geçirildi. Hastalar safra fistülü olan
(Grup A) ve safra fistülü olmayan (Grup B) olmak üzere iki gruba ayrıldı. Yaş,
cinsiyet, kist çapı, kist yerleşimi, laboratuvar testleri ve hastanede kalış
süresi kaydedildi. Bu parametreler gruplar arasında karşılaştırıldı.

Bulgular: Gruplar yaş ve cinsiyet açısından benzer özellikteydi
(p = 0,790 ve p=1,0 sırasıyla). Grup A’daki ortalama kist çapı grup B’den
anlamlı olarak büyüktü (p=0,001). Ortalama hastanede kalış süresi grup
A’da grup B’den uzundu (p=0,001). Kist lokalizasyonu ve AST, ALT, total
bilirubin, direk bilirubin değerleri açısından gruplar arasında fark yoktu (hepsi
için p>0.05).

Sonuç:
Ameliyat öncesi kist çapı, safra fistülünü tahmin etmek için faydalı bir
parametre olabilir. Bununla beraber, bu konuda daha geniş prospektif serilere ihtiyaç
vardır. 

Anahtar Kelimeler

Kist hidatik, karaciğer, safra fistülü, ERCP

Kaynakça

• 1. Kilic M, Yoldas O, Koc M, Keskek M, Karakose N, Ertan T, et al. Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter? Am J Surg. 2008;196:732-5.
• 2. Atahan K, Küpeli H, Deniz M, Gür S, Cökmez A, Tarcan E. Can occult cystobiliary fistulas in hepatic hydatid disease be predicted before surgery? Int J Med Sci. 2011;8:315-20.
• 3. Kayaalp C, Bostanci B, Yol S, Akoglu M. Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications. Am J Surg. 2003;185:175-9.
• 4. Ozaslan E, Bayraktar Y. Endoscopic therapy in the management of hepatobiliary hydatid disease. J Clin Gastroenterol. 2002;35:160-74.
• 5. Patkowski W, Krasnodębski M, Grąt M, Masior Ł, Krawczyk M. Surgical treatment of hepatic Echinococcus granulosus. Prz Gastroenterol. 2017;12:199-202.
• 6. Jabbari Nooghabi A, Mehrabi Bahar M, Asadi M, Jabbari Nooghabi M, Jangjoo A. Evaluation and Comparison of the Early Outcomes of Open and Laparoscopic Surgery of Liver Hydatid Cyst. Surg Laparosc Endosc Percutan Tech. 2015;25:403-7.
• 7. Baraket O, Moussa M, Ayed K, Kort B, Bouchoucha S. Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver. Arab J Gastroenterol. 2014;15:119-22.
• 8. Surmelioglu A, Ozer I, Reyhan E, Dalgic T, Ozdemir Y, Ulas M, et al. Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst. Am Surg. 2017;83:30-5.
• 9. El Nakeeb A, Salem A, El Sorogy M, Mahdy Y, Ellatif MA, Moneer A, et al. Cystobiliary communication in hepatic hydatid cyst: predictors and outcome. Turk J Gastroenterol. 2017;28:125-30.
• 10. Agarwal S, Sikora SS, Kumar A, Saxena R, Kapoor VK. Bile leaks following surgery for hepatic hydatid disease. Indian J Gastroenterol. 2005;24:55-58.
• 11. Balık AA, Başoğlu M, Celebi F, Oren D, Polat KY, Atamanalp SS, et al. Surgical treatment of hydatid disease of the liver: review of 304 cases. Arch Surg. 1999;134:166-9.
• 12. Vagioanos C, Androulakis JA. Capsulectomy and drainage in hepatic hydatidosis. Dig Surg. 1997;14:241-4.
• 13. Akaydin M, Erozgen F, Ersoy YE, Birol S, Kaplan R. Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures. Can J Surg. 2012;55:244-8.
• 14. Dolay K, Akçakaya A, Soybir G, Cabioğlu N, Müslümanoğlu M, Iğci A, Topuzlu C. Endoscopic sphincterotomy in the management of postoperative biliary fistula A complication of hepatic hydatid disease. Surg Endosc. 2002;16:985-8.
• 15. Bilsel Y, Bulut T, Yamaner S, Buyukuncu Y, Bugra D, Akyuz A, et al. ERCP in the diagnosis and management of complications after surgery for hepatic echinococcosis. Gastrointest Endosc. 2003;57:210-3.